Quantitative susceptibility mapping in neurodegenerative diseases: An umbrella review of iron-related biomarkers and mechanisms.
Sadegh Ghaderi, Sana Mohammadi, Yasser Iturria-Medina
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In 30 seconds
This umbrella review evaluates the role of quantitative susceptibility mapping (QSM) in assessing iron-related biomarkers across various neurodegenerative diseases (NDDs), including Parkinson's disease, Alzheimer's disease, and amyotrophic lateral sclerosis. The review includes 15 systematic reviews and meta-analyses, revealing that QSM demonstrates comparable or higher diagnostic sensitivity than conventional techniques, particularly in deep gray matter structures. Notably, significant iron overload in the substantia nigra correlates with motor severity in Parkinson's disease.
Key findings
- QSM shows comparable or higher diagnostic sensitivity than R2* and SWI techniques for deep gray matter structures.
- Significant iron overload in the substantia nigra correlates with motor severity and disease duration in Parkinson's disease.
- Elevated susceptibility in the putamen and globus pallidus distinguishes multiple system atrophy and progressive supranuclear palsy from idiopathic Parkinson's disease.
- Distinct susceptibility alterations in the thalamus, motor cortex, and hippocampus reflect different pathophysiological mechanisms in Alzheimer's disease and ALS.
Why it matters
Understanding the role of iron accumulation in neurodegenerative diseases can enhance diagnostic accuracy and inform treatment strategies. QSM may provide valuable insights into disease mechanisms and progression, aiding in the differentiation of various NDDs.
What to keep in mind
The included systematic reviews and meta-analyses were rated Low or Critically Low on AMSTAR 2, indicating low methodological quality.